Issues for testing in several situations
Testing individuals with indicators or signs in step with COVID-19
Employers could take into account conducting every day in-person or digital well being checks (e.g., symptom and temperature screening) to establish workers with indicators or signs in step with COVID-19 earlier than they enter a facility. Employers ought to observe steerage from the EEOCexterior icon concerning confidentiality of medical information from well being checks.
Vaccinated and unvaccinated employees with COVID-19 signs needs to be instantly separated from different workers, clients, and guests, and despatched dwelling or to a healthcare facility, relying on how extreme their signs are, and observe CDC steerage for caring for oneself. To forestall stigma and discrimination within the office, make worker well being screenings as non-public as attainable. CDC recommends that anybody with indicators or signs of COVID-19 be examined and observe the recommendation of their healthcare supplier. Ready for check outcomes previous to returning to work is really helpful to maintain probably contaminated employees out of the office.
Employers are inspired to implement versatile sick go away and supportive insurance policies and practices as a part of a complete strategy to forestall and cut back transmission amongst workers.
Optimistic check outcomes utilizing a viral check (NAAT or antigen) in individuals with indicators or signs in step with COVID-19 point out that the particular person has COVID-19 and shouldn’t come to work and will isolate at dwelling. Choices to discontinue isolation for employees with COVID-19 and permit them to return to the office could observe both a symptom-based, time-based, or a test-based technique (see Testing to find out decision of an infection beneath).
A damaging antigen check in individuals with indicators or signs of COVID-19 needs to be confirmed by a laboratory-based NAAT, a extra delicate check. Outcomes from NAATs are thought of the definitive end result when there’s a discrepancy between the antigen and NAAT check. For extra data, see the antigen check algorithms for group settingspdf icon and congregate settingspdf icon.
Case investigation is often initiated when a well being division receives a report from a laboratory or testing web site of a constructive SARS-CoV-2 viral check end result, or a report from a healthcare supplier of a affected person with a confirmed or possible analysis of COVID-19pdf iconexterior icon.
Totally vaccinated individuals who have come into shut contact with somebody with COVID-19 needs to be examined 5-7 days following the date of their publicity and put on a masks in public indoor settings for 14 days or till they obtain a damaging check end result. They need to isolate in the event that they check constructive.
Viral testing is really helpful for all unvaccinated shut contacts. Due to the potential for asymptomatic (not having signs) or pre-symptomatic (not but displaying signs) transmission of SARS-CoV-2, it can be crucial that unvaccinated people uncovered to individuals with recognized or suspected COVID-19 be shortly recognized and quarantined. Viral testing with NAATs or antigen checks can detect if these people are at the moment contaminated.
The well being division could ask the employer for help in figuring out shut contacts of the employee with SARS-CoV-2 an infection. Employers are inspired to work with public well being departments investigating instances of COVID-19 and tracing contacts to assist cut back the unfold of SARS-CoV-2 of their workplaces and communities.
As a result of there could also be a delay between the time an individual is uncovered to the virus and the time that virus might be detected by testing, early testing after publicity at a single time level could miss many infections. Testing that’s repeated at completely different cut-off dates, additionally known as serial testing, is extra more likely to detect an infection amongst shut contacts of a COVID-19 case than testing accomplished at a single cut-off date. Viral testing is really helpful for unvaccinated shut contacts of individuals with COVID-19 instantly after being recognized, and if damaging, once more in 5–7 days after final publicity or instantly if signs develop throughout quarantine.
Whereas CDC continues to advocate a 14-day quarantine for unvaccinated people who’re shut contacts of an individual with COVID-19, viral testing might also be used as a part of an choice to shorten the quarantine interval. Native public well being authorities decide and set up the quarantine choices for his or her jurisdictions. Shortening quarantine could enhance willingness to stick to public well being suggestions. Nevertheless, shortened quarantines with continued symptom monitoring and masking till Day 14 could also be much less efficient in stopping transmission of COVID-19 than the at the moment really helpful 14-day quarantine. In jurisdictions with shortened quarantine choices, workplaces with greater danger of SARS-CoV-2 introduction or transmission, or with potential for better damaging influence if workers turn into contaminated SARS-CoV-2 (see Varieties of workplaces beneath), can take into account proscribing unvaccinated employees from coming into the office till 14 days after their publicity.
Viral testing might also be thought of for unvaccinated individuals who might need been in shut contact with individuals identified with COVID-19 in collaboration with the native well being division if assets allow. A risk-based strategy to testing attainable contacts of an individual with confirmed COVID-19 could also be utilized. Such an strategy ought to consider the probability of publicity, which is affected by the traits of the office and the outcomes of contact investigations. In some settings, expanded screening testing (i.e., testing past individually recognized shut contacts to those that are attainable shut contacts), equivalent to concentrating on employees who labored in the identical space and through the identical shift, could also be thought of as a part of a technique to regulate the transmission of SARS-CoV-2 within the office. Employers are inspired to seek the advice of with state, native, territorial, and tribal well being departments to assist inform decision-making about expanded screening testing.
Excessive-risk settings which have demonstrated potential for fast and widespread dissemination of SARS-CoV-2 embody:
If workers are examined after shut contact or suspected shut contact with somebody who has a confirmed or possible analysis of COVID-19, care needs to be taken to tell these workers of their attainable publicity to SARS-CoV-2 within the office whereas sustaining confidentiality of the person with COVID-19, as required by the ADAexterior icon and in step with EEOC steerage concerning What You Ought to Know About COVID-19 and the ADA, the Rehabilitation Act, and Different EEO Legal guidelinesexterior icon.
The resolution to finish isolation and return to the office for workers with suspected or confirmed SARS-CoV-2 an infection needs to be made within the context of scientific and native circumstances. NAATs have detected SARS-CoV-2 RNA in some recovered individuals’s respiratory specimens for as much as 3 months after sickness onset however with out direct proof that virus that may replicate or trigger illness. Consequently, proof helps a time-based and symptom-based technique to find out when to discontinue isolation or different precautions moderately than a test-based technique. For individuals who’re severely immunocompromised, a test-based technique may very well be thought of in session with infectious illness specialists. For all others, a test-based technique is now not really helpful.
Below the ADA, employers are permitted to require a healthcare supplier’s wordexterior icon to confirm that workers are wholesome and capable of return to work. Nevertheless, as a sensible matter, employers needs to be conscious that healthcare supplier places of work and medical services could also be extraordinarily busy during times when group COVID-19 indicators are within the average to excessive classes (Desk 2) and should not be capable of present such documentation in a well timed method. In such instances, employers ought to take into account not requiring a healthcare supplier’s word for workers who’re sick to validate their sickness, qualify for sick go away, or to return to work. Most individuals with COVID-19 have delicate sickness, can recuperate at dwelling with out medical care, and might observe CDC suggestions to find out when to discontinue isolation and return to the office.